Inamdar Hospital

What is leptospira? by – Dr.Anand Tiwari

 What is leptospira?                                

  • It is a bacterial disease, caused by bacteria leptospira, spread through the urine of infected animals
  • Most commonly spread through rodents like rats, mice
  • Most common in warm climates
  • In developing country like India-most commonly affects farmers
  • Transmitted by water /soil contaminated by urine of infected animals coming in contact with  breaks in skin, eyes, mouth, nose


What are the presenting symptoms?

  • Incubation period i.e  the time from infection to symptom onset   is: 7-12 days
  • some infected people may have no symptoms
  • disease may occur in 2 phases
  • wide range of symptoms from mild to severe
  • high fever,headache,chills,muscle aches,vomiting,jaundice,abdominal pain,diarrhea, rash
  • after the first phase of above mentioned symptoms –the  patient may recover for a time and become ill again
  • if second phase occurs-it is more severe, may cause –kidney failure, liver failure or meningitits, and lung hemorrhages


How can one get infected?

  • Rats, mice, and moles are important primary hosts
  • A wide range of other mammals including dogs, deer, rabbits, hedgehogs, cows, sheep, swine, raccoons, and certain marine mammals carry and transmit the disease as secondary hosts
  • Transmitted through contact with water, food, or soil that contains urine from infected animals
  • Through  swallowing of contaminated food or water
  • Can also get transmitted through the skin, mucosal contact

What are the various tests that can be done?

  • For the first 7 days, bacteria is detected in Blood & CSF
  • After 7-10 days of bacteria detected in Urine
  • Diagnosis is confirmed with tests such as enzyme-linked immunosorbent assay (ELISA) and polymerase chain reaction (PCR)
  • MAT (microscopic agglutination test) is considered the gold standard in diagnosing leptospirosis
  • kidney function tests and liver function tests may also be deranged

What conditions can mimic leptospirosis?

  • dengue fever and other hemorrhagic fevers
  • hepatitis of various causes
  • viral meningitis
  • malaria
  • typhoid fever
  • mild forms should be distinguished from influenza and other related viral diseases

What are the preventive measures?

  • Effective rat control
  • Avoidance of urine contaminated water sources
  • During outbreaks in endemic regions-prophylaxis with Doxycycline once a week, with  doctors advise is used to minimize the risk of infection

What are available medical therapy?

  • Effective antibiotics include
  • doxycycline or penicillin
  • For more severe cases: cefotaxime or ceftriaxone are preferred antibiotics
  • In cases with kidney damage-dialysis may be required
  • corticosteroids in gradually reduced doses is recommended by some specialists in cases of severe hemorrhagic effects.
  • Administration of organ-specific care and treatment are essential in cases of kidney, liver, or heart involvement.
  • other supportive symptomatic  treatment  is given as required